We appreciate the comments by Dr Nazm and associates about our article, which looked at the outcome of raised intraocular pressure in uveitic eyes with and without a corticosteroid-induced hypertensive response.
Dr Nazm and associates have mentioned that increase in intraocular pressure in uveitis could be attributable to synechial angle closure. As a routine, all patients undergo gonioscopy when intraocular pressure is elevated and angle closure is extremely uncommon in our population. This may be because we use dilating agents when uveitis is active to prevent synechiae formation.
Regarding the use of intravitreous corticosteroid in patients who have exhibited previous corticosteroid hypertensive response to the initial intravitreous triamcinolone, we only consider repeating the injection in patients who have contraindications to or did not respond to systemic therapy previously and where initial intravitreous triamcinolone resulted in significant visual improvement. This has been clearly stated in our article discussion.
As demonstrated in our paper, we do not think that prostaglandin analogue use is contraindicated in patients with uveitis. In their letter, Dr Nazm and associates are referring to a previous article published by our group and support the use of this ocular antihypertensive treatment in patients with uveitis and uveitic macular edema.
Finally, we are very thankful to the authors for sharing their experience in the management of a case of bilateral high intraocular pressure after posterior sub-Tenon’s corticosteroid treatment where intraocular pressure–lowering surgery was required.